| NPI | 1427698083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME MC18291) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME LC20592) |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2021-10-26 |