| NPI | 1598728198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: R526808) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NC L002882) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2011-05-17 |