| NPI | 1124825609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 373H00000X Day Training/Habilitation Specialist | |
| 3747P1801X Technician, Personal Care Attendant | |
| 374K00000X Religious Nonmedical Practitioner | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2025-03-03 |
| Last Update Date | 2025-03-03 |