NPI | 1679813778 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA 691103) |
Additional Taxonomies | 101Y00000X Counselor |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-02-26 |
Last Update Date | 2017-05-16 |