| NPI | 1427488238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NY 895344) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: FL ND6682) |
| Enumeration Date | 2013-11-14 |
| Last Update Date | 2013-11-14 |