| NPI | 1841915253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: SC 2389) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2022-10-07 |
| Last Update Date | 2022-10-07 |