| NPI | 1407613144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OH LD.10480) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 133V00000X Dietitian, Registered (Licence: OH LPD.11028) | |
| Enumeration Date | 2024-02-29 |
| Last Update Date | 2024-03-08 |