| NPI | 1174693501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133NN1002X Nutritionist, Nutrition, Education |
| Additional Taxonomies | 132700000X Dietary Manager |
| 170100000X Medical Genetics, Ph.D. Medical Genetics | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2025-09-11 |