| NPI | 1427413731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NY 008547) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2015-12-31 |