| NPI | 1750797247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW03113) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: RI CSW02038) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2022-10-07 |