| NPI | 1932924339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-HQZYP) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: CA MPSS-HQBZYP) |
| Enumeration Date | 2024-11-20 |
| Last Update Date | 2024-11-20 |