| NPI | 1467726646 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator | 
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.1302551) | 
| Enumeration Date | 2012-03-06 | 
| Last Update Date | 2022-06-28 |