NPI | 1992331722 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.2404071) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.210322) |
Enumeration Date | 2020-03-12 |
Last Update Date | 2024-02-07 |