| NPI | 1962653246 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW019543) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 23909) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2024-11-21 |