| NPI | 1144029042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist (Licence: CA 225400000x) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2025-03-12 |
| Last Update Date | 2025-06-03 |