| NPI | 1255141628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic (Licence: OH 177747) |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-01-08 |