| NPI | 1306698550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: PA DN008627) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: NY 012026) |
| 171400000X Health & Wellness Coach (Licence: NY 012026) | |
| 133NN1002X Nutritionist, Nutrition, Education (Licence: PA DN008627) | |
| 171400000X Health & Wellness Coach (Licence: PA DN008627) | |
| 174H00000X Health Educator (Licence: PA DN008627) | |
| 133NN1002X Nutritionist, Nutrition, Education (Licence: NY 012026) | |
| 133N00000X Nutritionist (Licence: NY 012026) | |
| Enumeration Date | 2024-04-02 |
| Last Update Date | 2025-12-06 |