| NPI | 1366904542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YS0200X Counselor, School |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2019-04-05 |