| NPI | 1093467326 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 104982) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 125984) |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2024-09-18 |