| NPI | 1285440529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: MD 51487) |
| Additional Taxonomies | 1744R1102X Specialist, Research Study (Licence: MD 51487) |
| 374K00000X (Licence: MD 51487) | |
| Enumeration Date | 2024-12-10 |
| Last Update Date | 2024-12-10 |