| NPI | 1376395194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 372600000X Adult Companion |
| 171400000X Health & Wellness Coach | |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2024-04-04 |
| Last Update Date | 2024-04-04 |