NPI | 1770367542 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH C.2406518) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.2406518) |
Enumeration Date | 2023-08-23 |
Last Update Date | 2024-11-10 |