| NPI | 1083435309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 070052BP) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TR0400X Psychologist, Rehabilitation | |
| Enumeration Date | 2024-10-19 |
| Last Update Date | 2024-10-19 |