| NPI | 1679316145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: IL 164.000000) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MO 2014011385) |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-06-13 |