| NPI | 1154520872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: CA C29781214) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: CA C29781214) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2024-04-17 |