NPI | 1902052418 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 175T00000X Peer Specialist (Licence: CA MPSS-IFDRXN) |
Enumeration Date | 2008-08-15 |
Last Update Date | 2024-05-09 |