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 |