| NPI | 1073146270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA Ci33090621) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1348930519) |
| 171M00000X Case Manager/Care Coordinator (Licence: CA R1348930519) | |
| Enumeration Date | 2020-02-16 |
| Last Update Date | 2022-07-05 |