| NPI | 1992925143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 11649) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 041012) |
| 225400000X Rehabilitation Practitioner (Licence: CA 11649) | |
| 171M00000X Case Manager/Care Coordinator (Licence: CA 11649) | |
| 172V00000X Community Health Worker (Licence: CA 11649) | |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2023-06-12 |