| NPI | 1881300499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X Health & Wellness Coach (Licence: AZ 21073230) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: AZ 21073230) |
| 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management (Licence: AZ 21073230) | |
| 101YP1600X Counselor, Pastoral (Licence: AZ 21073230) | |
| Enumeration Date | 2023-01-26 |
| Last Update Date | 2023-01-26 |