NPI | 1588453229 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-FTHGML) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2025-04-30 |
Last Update Date | 2025-09-23 |