NPI | 1043575996 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 372600000X Adult Companion |
172V00000X Community Health Worker | |
Enumeration Date | 2012-07-06 |
Last Update Date | 2025-04-02 |