NPI | 1487973806 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-FRVBZK) |
Additional Taxonomies | 101Y00000X Counselor |
171M00000X Case Manager/Care Coordinator | |
172V00000X Community Health Worker | |
Enumeration Date | 2010-05-25 |
Last Update Date | 2023-11-30 |