| NPI | 1467183285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MO 2018041401) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: KS 2352) |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2022-06-22 |