NPI | 1508514894 |
---|---|
Other Name | KALEB POLLUM |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.026984) |
Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.106832) |
Enumeration Date | 2022-03-15 |
Last Update Date | 2024-04-04 |