| NPI | 1275134389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW04667) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: RI CSW02703) |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2025-12-08 |