| NPI | 1992806111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: ME SP417) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ME CC348) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-08 |