| NPI | 1194081455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC HHA0977) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2025-02-07 |