NPI | 1003161654 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225400000X Rehabilitation Practitioner |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: CA b9909913) |
Enumeration Date | 2012-07-19 |
Last Update Date | 2019-09-12 |