| NPI | 1861092447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Y00000X Clinical Exercise Physiologist (Licence: CA 1066261) |
| Additional Taxonomies | 174H00000X Health Educator |
| Enumeration Date | 2020-10-31 |
| Last Update Date | 2021-08-02 |