NPI | 1831359595 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.2303482-SUPV) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 17129) |
Enumeration Date | 2008-06-16 |
Last Update Date | 2025-09-26 |