NPI | 1689395873 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: UT F25-117252) |
Additional Taxonomies | 175T00000X Peer Specialist (Licence: UT 1783) |
Enumeration Date | 2022-09-07 |
Last Update Date | 2025-05-12 |