| NPI | 1467884692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1005X Dietitian, Registered, Nutrition, Renal (Licence: TX DT82256) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT82256) |
| 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: TX DT82256) | |
| 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: TX DT82256) | |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2014-09-15 |