NPI | 1093203549 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 16-CRM-207) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR THW000001533) |
Enumeration Date | 2018-04-30 |
Last Update Date | 2018-04-30 |