| NPI | 1316583867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1310600618) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2023-05-03 |