| NPI | 1902311194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH S.2102018-TRNE) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2017-12-10 |
| Last Update Date | 2022-07-27 |