NPI | 1396008967 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A3544289) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 012275) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 110726) | |
Enumeration Date | 2012-06-19 |
Last Update Date | 2012-06-19 |