| NPI | 1093177701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OH E0003889) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2018-06-22 |