| NPI | 1851691893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| 174400000X Specialist | |
| 225XP0019X Occupational Therapist, Physical Rehabilitation | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA 71212-826) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 246Z00000X Specialist/Technologist, Other | |
| 103TE1100X Psychologist, Exercise & Sports | |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2013-03-18 |