| NPI | 1497094254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: CA A051910720) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA RW6823) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A051910720) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2023-09-20 |