| NPI | 1295198992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A051500118) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 5933) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2024-05-09 |