| NPI | 1386289825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: CA 86116034) |
| Additional Taxonomies | 132700000X Dietary Manager (Licence: CA 340625) |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2021-03-31 |