| NPI | 1467511204 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: OH E.0001662-SUPV) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH E.0001662-SUPV) | 
| 101YM0800X Counselor, Mental Health (Licence: OH E.0001662-SUPV) | |
| Enumeration Date | 2006-12-07 | 
| Last Update Date | 2025-09-11 |