| NPI | 1952617813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA SOCIAL WORK STUDENT) |
| Enumeration Date | 2010-08-29 |
| Last Update Date | 2010-09-01 |