NPI | 1497113013 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker |
Additional Taxonomies | 101Y00000X Counselor |
171M00000X Case Manager/Care Coordinator | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-02-10 |
Last Update Date | 2023-10-06 |