| NPI | 1891933958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP1600X Counselor, Pastoral | |
| 175F00000X Naturopath | |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2024-09-11 |