NPI | 1144312919 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E0500370.SUPV) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C0500370) |
Enumeration Date | 2006-09-29 |
Last Update Date | 2013-03-17 |