NPI | 1780980771 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 102690) |
Additional Taxonomies | 104100000X Social Worker |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-02-08 |
Last Update Date | 2023-06-21 |