NPI | 1811238280 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA lCi11990518) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2013-03-11 |
Last Update Date | 2024-04-24 |