| NPI | 1194084277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: CO 0718) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO 0558) |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2015-03-18 |