| NPI | 1740917137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MA 5385-NU-NU) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NH 1328) |
| 133V00000X Dietitian, Registered (Licence: RI LDN01193) | |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2022-08-04 |