| NPI | 1427338813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: CA MPSS-YGTNBA) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2024-12-30 |