NPI | 1679167183 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 224Y00000X Clinical Exercise Physiologist (Licence: CA 1070508) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: CA 77199) |
Enumeration Date | 2021-02-24 |
Last Update Date | 2025-05-27 |