NPI | 1215305024 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 10376665-3502) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-09-10 |
Last Update Date | 2019-09-23 |