| NPI | 1457237331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach (Licence: CA 968AED3373) |
| Additional Taxonomies | 225800000X Recreation Therapist |
| Enumeration Date | 2025-08-14 |
| Last Update Date | 2025-08-14 |