| NPI | 1871439547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2026-04-27 |
| Last Update Date | 2026-05-15 |