| NPI | 1396167433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WA DI60285507) |
| 133V00000X Dietitian, Registered (Licence: OR LD-D-10170730) | |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2024-06-04 |