| NPI | 1073226494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X |
| Additional Taxonomies | 101YP1600X Counselor Pastoral |
| 374K00000X Religious Nonmedical Practitioner | |
| Enumeration Date | 2022-12-30 |
| Last Update Date | 2022-12-30 |