NPI | 1780076844 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 133N00000X Nutritionist (Licence: TX 5020) |
Additional Taxonomies | 183500000X Pharmacist (Licence: CA 61933) |
Enumeration Date | 2015-02-26 |
Last Update Date | 2015-02-26 |