| NPI | 1730209636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: MA 1678) |
| Additional Taxonomies | 133NN1002X Nutritionist Nutrition, Education (Licence: MA 1678) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2007-07-08 |