| NPI | 1932358157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: AL 225) |
| Additional Taxonomies | 133VN1005X Dietitian, Registered, Nutrition, Renal (Licence: AL 225) |
| 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: AL 225) | |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2008-09-11 |