| NPI | 1407317704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 19319) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1326931018) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A058430920) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2024-09-30 |