| NPI | 1659678118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 13118) |
| Additional Taxonomies | 1835N1003X Pharmacist, Nutrition Support (Licence: SC 21410352) |
| 133V00000X Dietitian, Registered | |
| 133NN1002X Nutritionist, Nutrition, Education | |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2015-03-24 |