| NPI | 1740697861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1005X Dietitian, Registered, Nutrition, Renal (Licence: FL ND 5340) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: FL ND 5340) |
| 133V00000X Dietitian, Registered (Licence: FL ND 5340) | |
| 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: FL ND 5340) | |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2014-07-21 |