| NPI | 1417286865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP2201X Registered Nurse, Ambulatory Care (Licence: CA 484279) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: CA RN484279) |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2014-04-21 |