| NPI | 1316134992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133NN1002X Nutritionist Nutrition, Education (Licence: CT 000825) |
| Additional Taxonomies | 163WD0400X Registered Nurse Diabetes Educator (Licence: CT 082032) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2007-11-13 |