| NPI | 1356654883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: DE 20100629122) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DE 20100629122) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2010-07-26 |