| NPI | 1447300991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 986) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2016-02-26 |