| NPI | 1376817676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 132700000X Dietary Manager |
| Additional Taxonomies | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: ME DI1080) |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2025-03-03 |