| NPI | 1194148627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach (Licence: CA 1F5ED6850F) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2025-06-02 |