| NPI | 1750723698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT04679) |
| 133VN1006X Dietitian, Registered, Nutrition, Metabolic | |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2013-07-19 |