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 |