| NPI | 1528472198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: NC L003460) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NC L003460) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2016-09-08 |