| NPI | 1467643924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA CAADE #200346) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA CAADAC #48488504) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA NADAC #013941) | |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2007-08-08 |