| NPI | 1770391120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X Health & Wellness Coach (Licence: CA 1503552) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: CA 1503552) |
| 224Y00000X Clinical Exercise Physiologist (Licence: CA 1503552) | |
| Enumeration Date | 2024-12-18 |
| Last Update Date | 2024-12-18 |