| NPI | 1417518739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: OK 2876) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WA 86102249) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2023-08-08 |