| NPI | 1437516572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW04458) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA LICSW1120871) |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2025-10-10 |