| NPI | 1629288675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X Health & Wellness Coach |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 004404-1) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2024-06-27 |