| NPI | 1013445428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA Ci07740517) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA Rii06011215) |
| 171M00000X Case Manager/Care Coordinator (Licence: CA Ci07740517) | |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2024-04-11 |