| NPI | 1992578678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 372600000X Adult Companion (Licence: CA APCC20443) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: CA APCC20443) |
| Enumeration Date | 2023-11-03 |
| Last Update Date | 2025-11-06 |