| NPI | 1841632528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 684-5-1-11-256) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ND 684-5-1-11-256) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2016-09-12 |