NPI | 1366644395 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI CSW02934) |
Additional Taxonomies | 104100000X Social Worker (Licence: MA none) |
Enumeration Date | 2007-06-01 |
Last Update Date | 2024-10-25 |