NPI | 1003634163 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-JUITLW) |
Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist |
Enumeration Date | 2024-09-27 |
Last Update Date | 2025-08-04 |