NPI | 1356187199 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW-113615) |
Additional Taxonomies | 172V00000X Community Health Worker (Licence: CA ASW-113615) |
101Y00000X Counselor (Licence: CA ASW-113615) | |
Enumeration Date | 2024-07-02 |
Last Update Date | 2024-09-12 |