NPI | 1760046106 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 126786) |
Additional Taxonomies | 101Y00000X Counselor |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-30 |
Last Update Date | 2024-11-01 |