| NPI | 1063058857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 226300000X Kinesiotherapist |
| Additional Taxonomies | 103TE1100X Psychologist Exercise & Sports |
| 133N00000X Nutritionist | |
| Enumeration Date | 2019-11-27 |
| Last Update Date | 2019-11-27 |