| NPI | 1003956111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor Pastoral |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 8793) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2025-09-11 |