| NPI | 1679615769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach (Licence: A-3273815) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 174H00000X Health Educator | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2024-06-17 |