| NPI | 1083113864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 0051) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 1233) | |
| 174400000X Specialist | |
| 175T00000X Peer Specialist (Licence: NH 0051) | |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2024-04-11 |