| NPI | 1871130591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133VN1006X Dietitian, Registered, Nutrition, Metabolic |
| 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management | |
| 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics | |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2019-12-20 |