NPI | 1063103331 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG61446393) |
Additional Taxonomies | 175T00000X Peer Specialist |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2023-05-17 |
Last Update Date | 2023-09-06 |