| NPI | 1902569148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-ZLYGHR) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 172V00000X Community Health Worker (Licence: CA MPSS-ZLYGHR) | |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2023-03-15 |