NPI | 1396455218 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-FVBCY) |
Additional Taxonomies | 172V00000X Community Health Worker |
175T00000X Peer Specialist | |
Enumeration Date | 2022-12-01 |
Last Update Date | 2023-05-25 |