| NPI | 1306567185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 133N00000X Nutritionist |
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2024-06-12 |