| NPI | 1558024208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TE1100X Psychologist, Exercise & Sports |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 171400000X Health & Wellness Coach | |
| 1744G0900X Specialist, Graphics Designer | |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2021-10-20 |