| NPI | 1265044275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: NY 010390) |
| Additional Taxonomies | 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2024-12-05 |