| NPI | 1457983488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.2203074) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH C.2002851) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: C.1901855-TRNE) | |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2023-11-27 |