NPI | 1174319164 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225400000X Rehabilitation Practitioner |
Additional Taxonomies | 175T00000X Peer Specialist (Licence: WA CG60829225) |
Enumeration Date | 2025-04-16 |
Last Update Date | 2025-04-16 |