| NPI | 1457073116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor Pastoral (Licence: LA JL860042) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: LA JL860042) |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2022-09-19 |