| NPI | 1841708393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA asw80999) |
| 172V00000X Community Health Worker | |
| 101Y00000X Counselor | |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2023-08-15 |