NPI | 1316465503 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 016868) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 011401) |
Enumeration Date | 2017-09-07 |
Last Update Date | 2017-09-07 |