NPI | 1588211825 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
172V00000X Community Health Worker | |
Enumeration Date | 2019-08-21 |
Last Update Date | 2024-05-15 |