| NPI | 1194992420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.0007672-SUPV) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C0007672) |
| 101Y00000X Counselor (Licence: OH E0007672) | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2021-12-27 |