| NPI | 1821627100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133NN1002X Nutritionist, Nutrition, Education |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2020-04-07 |