| NPI | 1528667953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: AZ D04019037) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ D04019037) |
| Enumeration Date | 2020-10-17 |
| Last Update Date | 2020-10-17 |