| NPI | 1396369682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.2203102) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2002595) |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2023-02-20 |