| NPI | 1831681295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.2203016) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101YP2500X Counselor, Professional (Licence: OH C.1801026) | |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2022-07-20 |