| NPI | 1144758087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH 1500188) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2024-02-15 |