NPI | 1336709419 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2019-06-19 |
Last Update Date | 2020-08-28 |