| NPI | 1528394491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0068447) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2026-06-16 |