| NPI | 1750118576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: CO 86043129) |
| Additional Taxonomies | 132700000X Dietary Manager (Licence: CO 86043129) |
| Enumeration Date | 2024-09-16 |
| Last Update Date | 2024-09-16 |