| NPI | 1073313102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 374J00000X Doula |
| 171M00000X Case Manager/Care Coordinator | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2025-03-17 |
| Last Update Date | 2025-03-17 |