NPI | 1417405119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 133NN1002X Nutritionist, Nutrition, Education (Licence: NY 000961-1) |
Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider (Licence: NY 000961-1) |
Enumeration Date | 2016-09-12 |
Last Update Date | 2016-09-12 |