NPI | 1770309379 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WA 61370767) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: WA DI61370767) |
Enumeration Date | 2024-11-27 |
Last Update Date | 2024-12-27 |