NPI | 1215692447 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 172V00000X Community Health Worker |
Enumeration Date | 2021-11-02 |
Last Update Date | 2024-02-14 |