NPI | 1285235085 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-YJHIER) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
172V00000X Community Health Worker | |
Enumeration Date | 2020-11-06 |
Last Update Date | 2024-08-07 |