| NPI | 1972161610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2208555) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251S00000X | |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2023-01-03 |