NPI | 1518478213 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E2303877) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH C.2103180) |
Enumeration Date | 2017-10-20 |
Last Update Date | 2023-11-17 |