| NPI | 1114400934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 10798-C) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 02295-I) |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2023-07-25 |