| NPI | 1770396103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X Health & Wellness Coach (Licence: CA 1190351195) |
| Additional Taxonomies | 224Y00000X Clinical Exercise Physiologist (Licence: CA 1200502608) |
| Enumeration Date | 2025-01-29 |
| Last Update Date | 2025-01-29 |