| NPI | 1235551573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW02785) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 085307) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2023-08-17 |