| NPI | 1649790254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133N00000X Nutritionist |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 133NN1002X Nutritionist, Nutrition, Education | |
| Enumeration Date | 2017-06-24 |
| Last Update Date | 2017-06-24 |