| NPI | 1790190155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133NN1002X Nutritionist, Nutrition, Education (Licence: AZ 778154) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: AZ 778154) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-06-24 |