NPI | 1922618271 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA ASW103836) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW103836) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-08-02 |
Last Update Date | 2024-09-04 |