| NPI | 1942012968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 372600000X Adult Companion |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2025-01-25 |
| Last Update Date | 2025-01-25 |