| NPI | 1407537962 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO LSW.0009925521) |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: CO Q221211) |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2024-10-22 |