| NPI | 1396217154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1308850618) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2022-06-28 |