| NPI | 1144688235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: MI 6401003958) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801018821) |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2016-02-03 |