| NPI | 1134555477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DE PC-0011858) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DE CD-0010167) |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2025-07-29 |