| NPI | 1154726370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 104100000X Social Worker | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2026-01-14 |