| NPI | 1871077131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.2303428) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH C..1901997) |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2023-09-14 |