NPI | 1023533361 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225C00000X Rehabilitation Counselor (Licence: CA 2012921) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-08-08 |
Last Update Date | 2022-07-21 |