| NPI | 1952178394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist (Licence: CA Y3520863) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2025-04-09 |