NPI | 1386998722 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA ELCNHZADVISPJUQM) |
Additional Taxonomies | 175T00000X Peer Specialist |
Enumeration Date | 2012-11-07 |
Last Update Date | 2022-12-13 |