| NPI | 1316433949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: CA A054951023) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A054951023) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2025-05-27 |