| NPI | 1841456134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.0500210) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.0500210) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2009-06-02 |