| NPI | 1265745152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 685) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: MN 468869) |
| 101YS0200X Counselor, School (Licence: ND 416266) | |
| 101YP2500X Counselor, Professional (Licence: ND 797-8-1-14) | |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2026-04-13 |