| NPI | 1427639459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NV 39960-DI-0) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CA 911745) |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2021-05-15 |