| NPI | 1104696707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver (Licence: CA e1713416) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 171M00000X Case Manager/Care Coordinator | |
| 225C00000X Rehabilitation Counselor | |
| 374K00000X Religious Nonmedical Practitioner | |
| Enumeration Date | 2024-01-04 |
| Last Update Date | 2024-01-04 |