NPI | 1275252009 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: CA 116620) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 116620) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-08-24 |
Last Update Date | 2025-06-25 |