| NPI | 1477148591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Y00000X Clinical Exercise Physiologist |
| Additional Taxonomies | 133N00000X Nutritionist |
| 174H00000X Health Educator | |
| 226300000X Kinesiotherapist | |
| Enumeration Date | 2021-03-02 |
| Last Update Date | 2023-06-16 |