| NPI | 1831605955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: WA RN60900940) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60478808) |
| 104100000X Social Worker | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2018-10-14 |