| NPI | 1770096059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: FL P00190) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 132700000X Dietary Manager (Licence: FL 328621) | |
| 133N00000X Nutritionist | |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 171400000X Health & Wellness Coach | |
| 174H00000X Health Educator | |
| 175F00000X Naturopath | |
| 282J00000X Religious Nonmedical Health Care Institution | |
| 374K00000X | |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2022-10-24 |