| NPI | 1710686258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Y00000X Clinical Exercise Physiologist |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.459594) |
| Enumeration Date | 2023-02-23 |
| Last Update Date | 2023-02-23 |