| NPI | 1487980546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1005X Dietitian, Registered, Nutrition, Renal (Licence: NC L004645) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: FL ND5526) |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2016-01-28 |