| NPI | 1942645916 |
|---|---|
| Former Name | EINSTEIN HICKMAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OR C5178) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 19-R-08) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2020-01-12 |