| NPI | 1922764968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW04193) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2024-10-23 |