| NPI | 1831528348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC16036) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME MC14329) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2020-06-04 |