NPI | 1508358698 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1288860218) |
Enumeration Date | 2018-06-04 |
Last Update Date | 2023-10-25 |