| NPI | 1477682441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 01-057128) |
| 172V00000X Community Health Worker | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA c4261214) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2025-09-17 |