| NPI | 1376945915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: MS JG719654D) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: MS JG71501X) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |