| NPI | 1679087373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2017-11-17 |
| Last Update Date | 2024-12-17 |