| NPI | 1295441707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6851121023) |
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2023-01-27 |
| Last Update Date | 2025-09-23 |