| NPI | 1326524463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH C.2002452) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.2002452) |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2022-11-07 |