| NPI | 1184953739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MT 59321) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2024-03-19 |