| NPI | 1831635853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133N00000X Nutritionist |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 133VN1006X Dietitian, Registered, Nutrition, Metabolic | |
| Enumeration Date | 2017-01-14 |
| Last Update Date | 2021-09-02 |