| NPI | 1518647486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist (Licence: CA MPSS-HOAMJW) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2025-04-03 |