| NPI | 1356656581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NE 966) |
| Additional Taxonomies | 133NN1002X Nutritionist Nutrition, Education (Licence: NE 966) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2011-02-18 |