NPI | 1326406323 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 7604) |
101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA R1292600218) | |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2016-02-04 |
Last Update Date | 2023-10-06 |