| NPI | 1295119998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: CA 347005168) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: CA 347005109) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2015-07-13 |