| NPI | 1215762075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach (Licence: FL T219847) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| 3747P1801X Technician, Personal Care Attendant (Licence: FL T219847) | |
| Enumeration Date | 2024-09-03 |
| Last Update Date | 2024-09-09 |