NPI | 1710682299 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW122858) |
Additional Taxonomies | 172V00000X Community Health Worker |
175T00000X Peer Specialist | |
Enumeration Date | 2023-04-03 |
Last Update Date | 2025-05-14 |