| NPI | 1447848908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA F4686499) |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2021-01-29 |