| NPI | 1013440379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: CA A060761221) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2024-05-06 |