| NPI | 1073458170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2026-04-23 |
| Last Update Date | 2026-04-23 |