| NPI | 1790894053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 0109811) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: NM 0109811) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2024-05-21 |