| NPI | 1922087634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.1201591) |
| Additional Taxonomies | 170300000X Genetic Counselor, MS |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2013-05-02 |