NPI | 1285897942 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: PR 2919) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PR 0288) |
Enumeration Date | 2008-07-02 |
Last Update Date | 2008-07-03 |