| NPI | 1205637626 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: DC 163WPO89X) |
| Enumeration Date | 2025-03-21 |
| Last Update Date | 2025-05-23 |