| NPI | 1376256701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MN 4948) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: IL 164009335) |
| Enumeration Date | 2022-12-30 |
| Last Update Date | 2025-01-03 |