NPI | 1003684622 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 125998) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
171M00000X Case Manager/Care Coordinator | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2023-12-13 |
Last Update Date | 2024-09-12 |