NPI | 1740819002 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OR 20030441LPN) |
Enumeration Date | 2020-04-07 |
Last Update Date | 2020-04-09 |