| NPI | 1841690419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA ASW139799) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2026-09-02 |