NPI | 1073135075 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1375370120) |
Enumeration Date | 2020-05-12 |
Last Update Date | 2024-08-13 |