| NPI | 1922770510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NY 86093624) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: NY 86093624) |
| 133NN1002X Nutritionist, Nutrition, Education (Licence: NY 86093624) | |
| 133VN1005X Dietitian, Registered, Nutrition, Renal (Licence: NY 86093624) | |
| 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management (Licence: NY 86093624) | |
| 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics (Licence: NY 86093624) | |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2021-10-01 |