| NPI | 1265738686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E7070) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2011-02-02 |