| NPI | 1902431000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist (Licence: CA 1902431000) |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2025-09-18 |