| NPI | 1912650060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X |
| Additional Taxonomies | 132700000X Dietary Manager |
| 133NN1002X Nutritionist Nutrition, Education | |
| 174H00000X Health Educator | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2022-01-29 |
| Last Update Date | 2022-01-29 |