| NPI | 1730717042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 86110767) |
| Additional Taxonomies | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management |
| 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics (Licence: 86110767) | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2022-05-31 |