| NPI | 1669806949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A035000816) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 13377) |
| 171M00000X Case Manager/Care Coordinator (Licence: CA A035000816) | |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2026-03-18 |