| NPI | 1730169913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OH 1.0007335) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OH I0007335) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2024-04-24 |