| NPI | 1366244832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X Health & Wellness Coach |
| Additional Taxonomies | 225CX0006X Rehabilitation Counselor, Orientation and Mobility Training Provider |
| Enumeration Date | 2025-03-26 |
| Last Update Date | 2025-03-26 |