| NPI | 1508231432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW02999) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: RI CSW01819) |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2021-08-30 |