| NPI | 1629468517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 68593) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2015-05-06 |