| NPI | 1639682537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH W.1900200) |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2021-05-05 |