| NPI | 1841521226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC13725) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME MC12410) |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2013-10-08 |