| NPI | 1437980752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NC L008627) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WV 1533) |
| 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics | |
| 133V00000X Dietitian, Registered (Licence: IL 164.008759) | |
| Enumeration Date | 2024-08-08 |
| Last Update Date | 2026-07-07 |