| NPI | 1699911750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW02158) |
| Additional Taxonomies | 104100000X Social Worker (Licence: RI CSW00528) |
| Enumeration Date | 2008-12-19 |
| Last Update Date | 2012-02-13 |