| NPI | 1982753984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E0000338) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: NE 323) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-08 |