NPI | 1548413461 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E0701097) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH C.07010977) |
Enumeration Date | 2008-10-23 |
Last Update Date | 2019-04-01 |