| NPI | 1801999461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ND 347319655) |
| Additional Taxonomies | 101YP1600X Counselor Pastoral (Licence: ND 347319655) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2022-11-14 |