| NPI | 1962208355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-YRCWZD) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 225400000X Rehabilitation Practitioner | |
| 372600000X Adult Companion | |
| Enumeration Date | 2025-02-25 |
| Last Update Date | 2026-02-18 |