NPI | 1043441140 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC169) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CCS2845) |
Enumeration Date | 2009-08-06 |
Last Update Date | 2009-08-06 |