NPI | 1972380699 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: LA 3489) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: LA 86176044) |
Enumeration Date | 2023-09-14 |
Last Update Date | 2023-09-25 |