NPI | 1841430303 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 1460) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA 1460) |
Enumeration Date | 2009-02-24 |
Last Update Date | 2009-02-24 |