| NPI | 1346386554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.0001503) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OH F0000071) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2015-11-19 |