| NPI | 1528792801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: OH CDCA.185422) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.2403737-TRNE) |
| Enumeration Date | 2022-07-13 |
| Last Update Date | 2024-08-22 |