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 |