| NPI | 1003885344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 13836) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2024-01-29 |