| NPI | 1598494882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH 0002282) |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2025-05-22 |