| NPI | 1295024495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: ME MC12688) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ME LS3689) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2015-03-27 |