| NPI | 1982276705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management |
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2021-07-12 |