NPI | 1821652512 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-28 |
Last Update Date | 2023-11-14 |