NPI | 1215217922 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2011-08-25 |
Last Update Date | 2012-10-12 |