| NPI | 1740149053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-DGIJHE) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2026-01-21 |
| Last Update Date | 2026-02-18 |