| NPI | 1750931986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.1904524) |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2023-05-03 |