| NPI | 1912036575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.0700886) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S0027574) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2011-12-29 |