NPI | 1487165411 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT89725) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NM LD-1133) |
Enumeration Date | 2017-10-17 |
Last Update Date | 2024-03-19 |