| NPI | 1548050487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH C.2607997) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.2406036-TRNE) |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2026-05-28 |