| NPI | 1881381572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: CA 86329725) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2025-05-29 |