| NPI | 1245866862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1101X Dietitian, Registered, Nutrition, Gerontological (Licence: MD C05672) |
| Additional Taxonomies | 133VN1101X Dietitian, Registered, Nutrition, Gerontological |
| Enumeration Date | 2020-03-15 |
| Last Update Date | 2022-09-20 |