| NPI | 1013495225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Y00000X Clinical Exercise Physiologist (Licence: IN 809638) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: IN 809638) |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2018-09-15 |