NPI | 1417984535 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 104100000X Social Worker (Licence: IN 33001138A) |
Enumeration Date | 2006-06-26 |
Last Update Date | 2011-08-08 |