| NPI | 1265763643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1005X Dietitian, Registered, Nutrition, Renal (Licence: NC L002986) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: NC L002986) |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2010-01-25 |