| NPI | 1841084357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW04549) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.021748) |
| Enumeration Date | 2025-04-08 |
| Last Update Date | 2025-12-12 |