NPI | 1114979986 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI isw01394) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 1024584) |
Enumeration Date | 2006-05-17 |
Last Update Date | 2007-11-09 |