| NPI | 1154013696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: VA 86170171) |
| Additional Taxonomies | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management (Licence: MA LDN6548) |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2025-02-04 |