| NPI | 1073941985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401013960) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401013960) |
| 101YM0800X Counselor, Mental Health (Licence: MI 6401013960) | |
| 101YP1600X Counselor, Pastoral (Licence: MI 6401013960) | |
| Enumeration Date | 2013-10-31 |
| Last Update Date | 2013-10-31 |