| NPI | 1952569097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 62871) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: TX 62871) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2011-06-13 |