| NPI | 1578305850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X Health & Wellness Coach |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 172V00000X Community Health Worker | |
| 175T00000X Peer Specialist | |
| 251S00000X | |
| Enumeration Date | 2024-06-10 |
| Last Update Date | 2024-06-27 |