| NPI | 1366878266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 2255R0406X Specialist/Technologist, Rehabilitation, Blind |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2013-09-24 |