| NPI | 1932664810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: WA NU60926852) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: WA NU60926852) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: WA NU60926852) | |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2019-02-05 |