| NPI | 1598691198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: UT 14237203-4901) |
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: UT 86415769) |
| Enumeration Date | 2026-06-22 |
| Last Update Date | 2026-09-29 |