| NPI | 1679812721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Y00000X Clinical Exercise Physiologist |
| Additional Taxonomies | 246QH0600X Specialist/Technologist, Pathology Histology |
| 1744R1102X Specialist Research Study | |
| 225400000X Rehabilitation Practitioner | |
| 246QM0900X Specialist/Technologist, Pathology Microbiology | |
| Enumeration Date | 2013-02-10 |
| Last Update Date | 2013-02-11 |