NPI | 1871842385 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: CA C3341214) |
Enumeration Date | 2012-08-30 |
Last Update Date | 2024-04-11 |