| NPI | 1336991983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV IC-2881) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 104100000X Social Worker (Licence: NV 12797-M) | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2024-04-04 |
| Last Update Date | 2026-02-20 |