| NPI | 1104223049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 174400000X Specialist (Licence: CA 46246) |
| 133NN1002X Nutritionist Nutrition, Education | |
| 225700000X Massage Therapist | |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2016-08-18 |