| NPI | 1972057735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach (Licence: Q242678848) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 104100000X Social Worker (Licence: WA CG60644590) | |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2021-06-22 |