NPI | 1194233809 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401222421) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OH C.1800915) |
101YP2500X Counselor Professional (Licence: MI 6451017189) | |
Enumeration Date | 2018-01-16 |
Last Update Date | 2022-01-07 |