| NPI | 1760849145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-YDHUGI) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2024-08-19 |