| NPI | 1588891600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: CA 5122008) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: CA 5122008) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2009-06-16 |