NPI | 1558943597 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 136A00000X Dietetic Technician, Registered (Licence: CA 86254119) |
Additional Taxonomies | 136A00000X Dietetic Technician, Registered |
Enumeration Date | 2021-04-27 |
Last Update Date | 2021-04-27 |