| NPI | 1457050700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: UT 86148619) |
| Additional Taxonomies | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: UT 86148619) |
| 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management (Licence: UT 86148619) | |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2025-07-30 |