| NPI | 1235392515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC4965) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 101YP2500X Counselor, Professional | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2025-07-23 |