| NPI | 1598493470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: RI ISW03601) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2022-08-09 |
| Last Update Date | 2024-08-07 |