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) |
Enumeration Date | 2010-06-09 |
Last Update Date | 2021-02-10 |