| NPI | 1174315162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Y00000X Clinical Exercise Physiologist |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 226300000X Kinesiotherapist | |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-05-19 |