| NPI | 1699945881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH PN 129343 IV) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2025-04-01 |