| NPI | 1477130557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701014672) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2025-03-27 |