NPI | 1952470825 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC002807) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA PC002807) |
Enumeration Date | 2006-11-07 |
Last Update Date | 2024-07-29 |