| NPI | 1538829239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: OH CDCA.182960) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OH CDCA.179294) |
| Enumeration Date | 2021-12-21 |
| Last Update Date | 2022-12-15 |