| NPI | 1194486001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 174H00000X Health Educator | |
| Enumeration Date | 2022-01-03 |
| Last Update Date | 2022-01-03 |