| NPI | 1699429555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AL C4029A) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2022-02-09 |