| NPI | 1225493299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-NLCYVG) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2023-11-27 |