| NPI | 1811388424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 32436) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN MATS-148) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN CCJP-1005) | |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2015-06-26 |