| NPI | 1750707741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: ME LC15926) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ME MC13917) |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2019-10-23 |