| NPI | 1932403748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: VA 0101019193) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: VA 0101019193) |
| Enumeration Date | 2011-01-08 |
| Last Update Date | 2011-01-08 |