NPI | 1023898723 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
Enumeration Date | 2023-10-02 |
Last Update Date | 2023-10-02 |