| NPI | 1033002316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-IPRKDS) |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist |
| Enumeration Date | 2025-06-03 |
| Last Update Date | 2025-06-12 |