| NPI | 1972040913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH S.1500068) |
| Enumeration Date | 2017-01-29 |
| Last Update Date | 2024-01-30 |