| NPI | 1265139471 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM SWB-2024-0781) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: NM 34406) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-02-08 |
| Last Update Date | 2024-09-10 |