| NPI | 1730737321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1006X Dietitian, Registered, Nutrition, Metabolic |
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 133V00000X Dietitian, Registered | |
| 133N00000X Nutritionist | |
| 133VN1005X Dietitian, Registered, Nutrition, Renal | |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2019-11-07 |