| NPI | 1184038952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH 4604) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OH F.0000043) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2022-06-28 |