| NPI | 1770622961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 170300000X Genetic Counselor, MS |
| 170300000X Genetic Counselor, MS | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2022-12-09 |