| NPI | 1154069045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW023231) |
| Additional Taxonomies | 104100000X Social Worker (Licence: RI ISW03231) |
| Enumeration Date | 2022-05-22 |
| Last Update Date | 2022-05-31 |