| NPI | 1124904529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: TX 18090) |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| Enumeration Date | 2025-08-12 |
| Last Update Date | 2025-08-12 |