NPI | 1740320654 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: HI 3632) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: HI 1465-09) |
Enumeration Date | 2007-02-08 |
Last Update Date | 2011-12-06 |