| NPI | 1033761333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 2470A2800X Technician, Health Information, Assistant Record Technician |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2019-07-19 |