| NPI | 1497350045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH LCDCII.161948) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCA.177324) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCA.174448) | |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2023-10-31 |