| NPI | 1962220285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH 000840758) |
| Enumeration Date | 2024-09-26 |
| Last Update Date | 2024-10-24 |