| NPI | 1023683323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 1122-5-1-21-592) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ND 5527) |
| 101YP2500X Counselor, Professional (Licence: ND 1122-5-1-21A) | |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2024-10-23 |