| NPI | 1306094297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME MC11253) |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2018-11-08 |