| NPI | 1225518855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.1502018) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH S.1502018) |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2018-08-14 |