| NPI | 1952711103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA PCCI1752) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2016-02-04 |