| NPI | 1427821925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 174400000X Specialist |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2025-05-14 |