| NPI | 1174475263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP1600X Counselor, Pastoral | |
| 225A00000X Music Therapist | |
| Enumeration Date | 2026-02-11 |
| Last Update Date | 2026-03-03 |