| NPI | 1083372924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach (Licence: NC A-3527446) |
| Additional Taxonomies | 174H00000X Health Educator |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2025-12-09 |