NPI | 1497267116 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: OH 00678) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OH CDCA.164909) |
Enumeration Date | 2017-11-03 |
Last Update Date | 2019-10-04 |