| NPI | 1659781748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME MC16402) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2017-10-26 |