NPI | 1477351310 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
Additional Taxonomies | 172V00000X Community Health Worker |
175T00000X Peer Specialist (Licence: MPSS-GXWVCS) | |
Enumeration Date | 2025-03-06 |
Last Update Date | 2025-05-27 |