NPI | 1609541481 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX 86036550) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT84198) |
Enumeration Date | 2021-08-12 |
Last Update Date | 2023-08-07 |