| NPI | 1992504591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NV 40366-DI-0) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CA 86099976) |
| Enumeration Date | 2025-03-07 |
| Last Update Date | 2025-03-07 |