| NPI | 1962113548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1744R1102X Specialist, Research Study |
| Additional Taxonomies | 246ZB0500X Specialist/Technologist, Other, Biochemist |
| 172A00000X Driver (Licence: AZ D06300831) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| 246ZB0301X Specialist/Technologist, Other, Biomedical Engineering | |
| Enumeration Date | 2022-12-05 |
| Last Update Date | 2023-01-04 |