| NPI | 1730999616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2608016) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH C.2406289-TRNE) |
| Enumeration Date | 2025-01-13 |
| Last Update Date | 2026-06-03 |