| NPI | 1639156359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: PA MF000184) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2025-09-11 |