| NPI | 1669254447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: IL 86133177) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CT 3284) |
| 133V00000X Dietitian, Registered (Licence: NC L007760) | |
| 133V00000X Dietitian, Registered (Licence: MN 5203) | |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2026-07-20 |