| NPI | 1700337714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133NN1002X Nutritionist Nutrition, Education |
| Additional Taxonomies | 225XP0019X Occupational Therapist Physical Rehabilitation |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2016-10-14 |