| NPI | 1467510289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E3127) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH E0003127) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2015-12-28 |