| NPI | 1205483542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 130888-121) |
| 174H00000X Health Educator | |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2024-04-12 |