| NPI | 1881264521 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 099464) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 108469) |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2025-02-21 |