| NPI | 1780220350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: ND 916-9-1-17-368) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: ND 916-9-1-17) |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2020-02-25 |