| NPI | 1295233468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156F00000X Technician/Technologist |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician |
| 246Y00000X Specialist/Technologist, Health Information | |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2021-09-17 |