NPI | 1013129667 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-SGAKIX) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2007-05-04 |
Last Update Date | 2024-08-27 |