| NPI | 1811332885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701005420) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| Enumeration Date | 2013-05-05 |
| Last Update Date | 2013-05-05 |