NPI | 1881122794 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.2002019) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH 1600498) |
Enumeration Date | 2017-05-23 |
Last Update Date | 2020-12-02 |