| NPI | 1396332326 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2106032)  | 
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator | 
| Enumeration Date | 2020-12-23 | 
| Last Update Date | 2021-04-16 |