NPI | 1720446636 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NC L005004) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MO 2015018923) |
Enumeration Date | 2016-02-05 |
Last Update Date | 2022-12-30 |