| NPI | 1407151012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OH LD.08248) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WI 3825-29) |
| 133V00000X Dietitian, Registered (Licence: MN 4907) | |
| 133V00000X Dietitian, Registered (Licence: KS 2712) | |
| 133V00000X Dietitian, Registered (Licence: AK 159679) | |
| 133V00000X Dietitian, Registered (Licence: SD 0813) | |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2024-06-11 |