| NPI | 1699399774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH C.2103203) |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2021-03-23 |