| NPI | 1376240317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X Health & Wellness Coach |
| Additional Taxonomies | 101Y00000X Counselor |
| 132700000X Dietary Manager | |
| 133N00000X Nutritionist | |
| 171100000X Acupuncturist | |
| 174H00000X Health Educator | |
| 225100000X Physical Therapist | |
| 225700000X Massage Therapist | |
| 332U00000X Home Delivered Meals | |
| 374T00000X Religious Nonmedical Nursing Personnel | |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2023-02-09 |