| NPI | 1245357474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E 0500265) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: OH 6269) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2007-07-08 |