NPI | 1366092827 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MN 4733) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: GA LD005394) |
Enumeration Date | 2019-09-17 |
Last Update Date | 2023-06-27 |