| NPI | 1285388801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 3298768928) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| Enumeration Date | 2022-02-11 |
| Last Update Date | 2022-02-11 |