| NPI | 1528808748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MT 86095918) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: MT 86095918) |
| Enumeration Date | 2024-05-27 |
| Last Update Date | 2024-05-27 |