| NPI | 1093565608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 171400000X Health & Wellness Coach (Licence: CA 449B172AB8) | |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2025-10-07 |