| NPI | 1245550524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW02929) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 077539-1) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2025-06-17 |