NPI | 1801192760 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 113174) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW84038) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-02-09 |
Last Update Date | 2023-01-20 |