NPI | 1750545570 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: HI 3031) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: HI 1558-10) |
Enumeration Date | 2008-07-10 |
Last Update Date | 2013-11-13 |