| NPI | 1144926213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133NN1002X Nutritionist, Nutrition, Education |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2023-08-11 |