| NPI | 1699360883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA Ci33360721) |
| Additional Taxonomies | 376J00000X Homemaker |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2022-01-28 |