| NPI | 1699972729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH RN.212655) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E0003477) |
| 101YP1600X Counselor, Pastoral (Licence: OH E0003477) | |
| 101YP2500X Counselor, Professional (Licence: OH E0003477) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2021-05-26 |