NPI | 1699256123 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2203341) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH S.190380) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: OH S.1800511-TRNE) | |
Enumeration Date | 2018-08-23 |
Last Update Date | 2024-01-29 |