| NPI | 1730958927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist (Licence: CA 1730958927) |
| Enumeration Date | 2023-12-28 |
| Last Update Date | 2025-09-15 |