| NPI | 1396076998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| 174H00000X Health Educator | |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2010-01-20 |