| NPI | 1427538479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NH 2833) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 1293) | |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2024-04-19 |