| NPI | 1427608207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH C.1902256) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E.2303839) |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2024-08-07 |