| NPI | 1558789479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: IL 164003714) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MO 2014006008) |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2014-03-29 |