NPI | 1932978822 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA R15275309923) |
Additional Taxonomies | 172V00000X Community Health Worker |
Enumeration Date | 2023-12-20 |
Last Update Date | 2023-12-20 |