| NPI | 1770475048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374K00000X Religious Nonmedical Practitioner |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 174H00000X Health Educator | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2025-07-19 |
| Last Update Date | 2025-07-27 |