NPI | 1609173673 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041S0200X Social Worker, School (Licence: ME LC1169) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME LC1169) |
Enumeration Date | 2011-02-28 |
Last Update Date | 2011-02-28 |