| NPI | 1043027600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: CA MPSS-CNMGUP) |
| Enumeration Date | 2024-12-16 |
| Last Update Date | 2024-12-26 |