| NPI | 1295552321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YS0200X Counselor, School (Licence: CA 240042053) |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| Enumeration Date | 2024-09-20 |
| Last Update Date | 2025-03-06 |