| NPI | 1548789233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2020-11-29 |