| NPI | 1427445543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0002397) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2021-01-19 |