| NPI | 1942267950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39000607 A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C5496) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2007-07-09 |