| NPI | 1518657220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: FL ND6904) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: GA LD006496) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-05-08 |