| NPI | 1215756796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 372600000X Adult Companion |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2024-10-10 |
| Last Update Date | 2024-10-10 |