| NPI | 1245633015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: TX 770326) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2014-10-07 |