NPI | 1477226363 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1427850421) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA R1427850421) |
Enumeration Date | 2021-07-27 |
Last Update Date | 2021-07-27 |