| NPI | 1790451557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH C.2305595) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.2002474-TRNE) |
| 101YP2500X Counselor, Professional (Licence: OH C.2002474-TRNE) | |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2023-11-14 |