| NPI | 1992822217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MD DX2677) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: MD DX2677) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2007-11-27 |