| NPI | 1679755862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: CA 833369) |
| Additional Taxonomies | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: CA CDE 2021-0283) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2007-11-29 |