| NPI | 1255716676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| 174H00000X Health Educator (Licence: WI R0059417FA) | |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2015-07-27 |