| NPI | 1861721961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E0022548) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH s-0022548) |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2009-12-18 |