| NPI | 1346371077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: FL LCMFT0241021200) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: FL LCMFT0241021200) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2016-01-15 |