| NPI | 1255755492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT83081) |
| Additional Taxonomies | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management (Licence: TX DT83081) |
| 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics (Licence: TX DT83081) | |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2024-01-18 |