| NPI | 1871373571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OH 171m00000x) |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2024-10-30 |