| NPI | 1467511204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH E.0001662-SUPV) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.0001662-SUPV) |
| 101YP1600X Counselor, Pastoral (Licence: OH E.0001662-SUPV) | |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2007-07-08 |