| NPI | 1538767397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT86304) |
| 133VN1301X Dietitian, Registered, Nutrition, Oncology | |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2023-10-20 |