| NPI | 1437866043 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-QKPUTJ) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1451801221) |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2024-04-19 |