NPI | 1861185381 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0704015871) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0704015871) |
Enumeration Date | 2023-05-31 |
Last Update Date | 2023-06-01 |