| NPI | 1740647593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: WA NU 60611293) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| 174H00000X Health Educator | |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2019-09-19 |