| NPI | 1093177701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 7381) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E.0003889-SUPV) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2025-09-29 |