| NPI | 1265509954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: TN 0000000011) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TN 0000001195) |
| 101YP2500X Counselor, Professional (Licence: NC 3205) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2009-09-14 |