NPI | 1801401963 |
---|---|
Former Name | MANUEL GAMBINO |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1389220520) |
Enumeration Date | 2020-09-14 |
Last Update Date | 2021-12-07 |