| NPI | 1306176334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: UT 7303483-4901) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: IL #1002013) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2010-01-15 |