NPI | 1205560844 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 172V00000X Community Health Worker |
Enumeration Date | 2022-07-11 |
Last Update Date | 2024-10-07 |