| NPI | 1659698926 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: FL BA 74721) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL BA 74721) | 
| Enumeration Date | 2010-04-27 | 
| Last Update Date | 2010-04-27 |