| 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 |