| NPI | 1467530717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor Pastoral (Licence: OK 200438) |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other (Licence: OK 2141) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |