| NPI | 1427079086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: RI CSW02903) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: RI LCDP00368) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2022-11-16 |