| NPI | 1699007831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: OH RN196294) |
| Enumeration Date | 2010-02-12 |
| Last Update Date | 2021-11-23 |