| NPI | 1588204804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 132700000X Dietary Manager | |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 224Y00000X Clinical Exercise Physiologist | |
| 251S00000X | |
| 293D00000X Physiological Laboratory | |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2020-02-06 |