NPI | 1568227254 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT001555A) |
Additional Taxonomies | 224Y00000X Clinical Exercise Physiologist |
Enumeration Date | 2024-02-21 |
Last Update Date | 2024-02-21 |