| NPI | 1235621731 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2511922)  | 
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.2302980-TRNE)  | 
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-05-31 | 
| Last Update Date | 2025-04-01 |