| NPI | 1275121998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 103864) |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2023-06-29 |