| NPI | 1437839131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NC L004070) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CT 2163) |
| Enumeration Date | 2023-07-19 |
| Last Update Date | 2023-07-19 |