NPI | 1508298324 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: KS 1792) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MO 2012035391) |
Enumeration Date | 2013-08-02 |
Last Update Date | 2013-08-02 |