NPI | 1285304634 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: CA 111035) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 111035) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-09-16 |
Last Update Date | 2023-08-16 |