| NPI | 1235535253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005943) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2020-08-28 |