| NPI | 1659915296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LPC013026) |
| Additional Taxonomies | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management (Licence: GA LD004005) |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2024-07-29 |