| NPI | 1407402407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2507009) |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2026-06-05 |