| NPI | 1437292539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA CADTP1694) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2023-08-01 |