NPI | 1447383070 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA Aii5251214) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: CA Aii5251214) |
Enumeration Date | 2007-03-13 |
Last Update Date | 2019-01-10 |