| NPI | 1174167951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 104100000X Social Worker (Licence: UT 12396010-3503) |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2023-09-18 |