| NPI | 1417165390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: VA 6637) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701002224) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2025-09-11 |