NPI | 1033402797 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: CA 10072014) |
Additional Taxonomies | 225800000X Recreation Therapist (Licence: CA 260192) |
Enumeration Date | 2011-05-26 |
Last Update Date | 2023-04-27 |