| NPI | 1205227063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA MONTGAM114NZ) |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2016-08-22 |