NPI | 1831717685 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA AMFT129074) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-07-08 |
Last Update Date | 2021-11-05 |