| NPI | 1902149677 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM SWB-2022-0044) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NM X-07932) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2023-09-20 |