| NPI | 1184763146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E0003540) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E3540) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2013-11-14 |