| NPI | 1154520872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: CA C29781214) |
| 172V00000X Community Health Worker (Licence: CA C29781214) | |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2025-05-02 |