| NPI | 1043041155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2403575-TRNE) |
| Additional Taxonomies | 104100000X Social Worker |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2024-08-10 |
| Last Update Date | 2025-08-25 |