| NPI | 1003332594 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: UT 14185146-3503) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2024-12-16 |