| NPI | 1609761139 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW131660) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2025-06-12 |
| Last Update Date | 2025-07-11 |