| NPI | 1801528914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 86075789) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NC L005785) |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2022-06-28 |