| NPI | 1952571093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.1200171-SUPV) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH E.1200171) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2024-09-03 |