| NPI | 1942880810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 1036-11-1-19-449) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ND 1036-11-1-19A) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2021-04-13 |
| Last Update Date | 2022-02-09 |