| NPI | 1144278797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 000285) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2007-07-08 |