| NPI | 1992475842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X |
| Additional Taxonomies | 174H00000X Health Educator |
| 225400000X Rehabilitation Practitioner | |
| 226300000X Kinesiotherapist | |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2021-09-13 |