| NPI | 1659722486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW102825) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 1239753) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2024-03-19 |