NPI | 1306622782 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW126440) |
Additional Taxonomies | 172V00000X Community Health Worker |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2023-09-01 |
Last Update Date | 2024-10-03 |