| NPI | 1407469331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2020-08-29 |
| Last Update Date | 2020-08-29 |