NPI | 1013483973 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: OH CDCA.174799) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OH CDCA.170860) |
Enumeration Date | 2018-10-18 |
Last Update Date | 2020-11-06 |