NPI | 1518222421 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: CA 89491) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-07-06 |
Last Update Date | 2022-09-08 |