NPI | 1407975204 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-CVHTBE) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2007-03-29 |
Last Update Date | 2023-09-14 |