| NPI | 1447527080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376G00000X Nursing Home Administrator (Licence: NC FCL-060-121) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2012-06-26 |