| NPI | 1558162891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-ZTGPEQ) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2025-03-22 |
| Last Update Date | 2026-03-24 |