| NPI | 1992536049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: PR 2111) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: PR 2111) |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2026-02-15 |