| NPI | 1497232680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: WV 150122417) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: WV 150122417) |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2018-07-20 |