| NPI | 1114181179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor Pastoral (Licence: FL 1251) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL 47174) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2008-07-17 |