NPI | 1295515443 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-TCELSZ) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2023-10-04 |
Last Update Date | 2024-03-01 |