| NPI | 1700210010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 996-3-1-19A) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2019-03-18 |