| NPI | 1659114734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 171M00000X Case Manager/Care Coordinator | |
| 374K00000X Religious Nonmedical Practitioner | |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2024-06-21 |