| NPI | 1629453097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: IL 164006502) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MO 2012036779) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2015-07-27 |