| NPI | 1427669886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WA 60683752) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OR 10177144) |
| 133V00000X Dietitian, Registered (Licence: NV 39486-DI-0) | |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-10 |