| NPI | 1942021423 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09932875) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CO SWC.0000000880) |
| Enumeration Date | 2024-10-18 |
| Last Update Date | 2026-03-12 |