| NPI | 1346089638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 86119842) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NY 011296) |
| Enumeration Date | 2024-05-24 |
| Last Update Date | 2024-05-24 |