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Individual
XAVIER WILSON
Active
Individual
XAVIER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
814644
ADA
NJ
Enumeration date
04/27/2007
Last updated
07/26/2019
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