NPI | 1912386319 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA RS8311A) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2015-05-19 |
Last Update Date | 2024-04-10 |