| NPI | 1790302057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1005X Dietitian, Registered, Nutrition, Renal |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OH LD.09168) |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2023-08-15 |