| NPI | 1730858481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WI 3684-29) |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2024-03-30 |