| NPI | 1356706972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: NJ Not Required) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: NJ Not Required) |
| Enumeration Date | 2015-12-26 |
| Last Update Date | 2020-10-27 |