NPI | 1275321937 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-GVZPKR) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2025-04-30 |
Last Update Date | 2025-05-08 |