| NPI | 1992543532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management (Licence: LA 3560) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: LA 3560) |
| 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: LA 3560) | |
| Enumeration Date | 2024-07-17 |
| Last Update Date | 2024-07-17 |