| NPI | 1770282469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NV 40394-DI-1) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2023-03-01 |
| Last Update Date | 2025-06-05 |