| NPI | 1568351047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-QUIHOC) |
| Additional Taxonomies | 171400000X Health & Wellness Coach (Licence: CA 15126C1C55) |
| Enumeration Date | 2025-06-30 |
| Last Update Date | 2025-06-30 |