| NPI | 1922040146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH 9534) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH 9534) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2007-07-08 |