| NPI | 1225610298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: OH SM251752) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2021-05-05 |