| NPI | 1437283439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2025-05-08 |