| NPI | 1750458402 |
|---|---|
| Other Name | RICHARD DEAN WALLACE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: MT 450) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MT 450) |
| 171100000X Acupuncturist (Licence: MT 162) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2007-07-08 |