| NPI | 1194559716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: CA MPSS-ZHUKJQ) |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2024-08-27 |
| Last Update Date | 2026-03-16 |