| NPI | 1457943946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Y00000X Clinical Exercise Physiologist |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: NJ 607851) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| 246Z00000X Specialist/Technologist, Other | |
| Enumeration Date | 2021-02-06 |
| Last Update Date | 2022-05-23 |