| NPI | 1750859385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: ME LC19610) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ME MC17740) |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2021-11-04 |