| NPI | 1033681895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.2102209-TRNE) |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2022-11-29 |