| NPI | 1053538975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 7971378-6004) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 101YP2500X Counselor, Professional (Licence: UT 7971378-6004) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2018-12-24 |