| NPI | 1275268492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: RI LDN01196) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 5613-NU-NU) |
| Enumeration Date | 2022-07-21 |
| Last Update Date | 2022-07-21 |