| NPI | 1275045403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH APS.001245) |
| Enumeration Date | 2017-10-27 |
| Last Update Date | 2023-11-01 |