| NPI | 1770675134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 943) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: NE 2985) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2017-01-18 |