| NPI | 1558005942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL IMH22614) |
| Additional Taxonomies | 174V00000X Clinical Ethicist |
| 101Y00000X Counselor | |
| 101YP1600X Counselor Pastoral | |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2023-06-14 |