| NPI | 1700245743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW107664) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA B0000190519) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2024-03-04 |