NPI | 1073328712 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171400000X Health & Wellness Coach (Licence: CA 4236E30E12) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 15895) |
Enumeration Date | 2025-02-10 |
Last Update Date | 2025-02-11 |