| NPI | 1437382538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374K00000X Religious Nonmedical Practitioner (Licence: OK 114477) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2023-08-17 |