| NPI | 1528435716 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 128558) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 78867) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2025-02-07 |