| NPI | 1235774027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: CA 86117763) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: CO 27630) |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2023-02-21 |