| NPI | 1417208380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SD LPCMH2422) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: SD Ordained 248986 2) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2024-11-01 |