| NPI | 1861236903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: IL 164.011343) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WI 5820-29) |
| 133V00000X Dietitian, Registered (Licence: MO 2023034183) | |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2025-06-01 |