NPI | 1821058702 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW01717) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 104905) |
Enumeration Date | 2006-03-24 |
Last Update Date | 2015-12-04 |