| NPI | 1528596012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW02952) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: RI CSW01841) |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2019-10-27 |