| NPI | 1245794163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach |
| Additional Taxonomies | 224Y00000X Clinical Exercise Physiologist |
| 174H00000X Health Educator | |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2024-06-05 |