| NPI | 1851981138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 14425-RAC) |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2025-11-19 |