| NPI | 1467066688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 1082-9-1-20-544) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ND 1082-9-1-20) |
| 101YM0800X Counselor, Mental Health (Licence: ND 1082-9-1-20A) | |
| 101YP2500X Counselor, Professional (Licence: ND 1082-9-1-20A) | |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2026-09-10 |