NPI | 1013466499 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
Additional Taxonomies | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management |
174H00000X Health Educator | |
Enumeration Date | 2016-09-27 |
Last Update Date | 2020-02-20 |