| NPI | 1649104233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-PCSMEH) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 94-3303140) |
| Enumeration Date | 2026-06-10 |
| Last Update Date | 2026-07-06 |