| NPI | 1801216528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor Pastoral (Licence: FL 7660) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC1900X Psychologist Counseling | |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2014-04-21 |