NPI | 1770968349 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW01315) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 000041) |
Enumeration Date | 2015-07-24 |
Last Update Date | 2015-08-11 |