| NPI | 1447929039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW03967) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: RI CSW02606) |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2024-01-08 |