NPI | 1376193102 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-09-13 |
Last Update Date | 2024-10-17 |