| NPI | 1881351708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1445710921) |
| Enumeration Date | 2021-11-27 |
| Last Update Date | 2025-03-10 |