| NPI | 1306065081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW01917) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: RI CSW00952) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2025-06-26 |