| NPI | 1982824264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133N00000X Nutritionist |
| 133NN1002X Nutritionist, Nutrition, Education | |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2019-07-26 |