| NPI | 1639814643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics (Licence: MD DX5606) |
| Additional Taxonomies | 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics (Licence: GA LD006072) |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2022-05-03 |