| NPI | 1285909853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) |
| 1744R1102X Specialist Research Study | |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2012-03-15 |