| NPI | 1124627252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: CA 00999407) |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2021-07-07 |