| NPI | 1487251492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: PR 86148575) |
| Additional Taxonomies | 133NN1002X Nutritionist Nutrition, Education (Licence: PR 2143) |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2025-05-05 |