| NPI | 1598215303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OH 3941) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: IL 393755) |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2016-10-05 |