| NPI | 1245186014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2613562) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2026-03-05 |
| Last Update Date | 2026-03-10 |