| NPI | 1811471196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A060990222) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1323400918) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA Ci28990220) | |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2023-02-28 |