| NPI | 1346591328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: 1063446) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2019-12-04 |