NPI | 1083222434 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: WA CO61026236) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: WA CO61026236) | |
Enumeration Date | 2020-07-21 |
Last Update Date | 2023-02-28 |