NPI | 1831494400 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG60130541) |
Additional Taxonomies | 376K00000X Nurse's Aide (Licence: WA NA00197940) |
Enumeration Date | 2011-01-12 |
Last Update Date | 2011-01-12 |