| NPI | 1518041086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 188-9-1-91-41) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ND 514) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2017-05-01 |