| NPI | 1285303172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: AZ 86276869) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2022-12-22 |