| NPI | 1245481233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1005X Dietitian, Registered, Nutrition, Renal (Licence: FL ND6583) |
| Additional Taxonomies | 133VN1005X Dietitian, Registered, Nutrition, Renal (Licence: NY 003565) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2018-06-16 |