| NPI | 1447867072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: MI 6802089266) |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2025-08-15 |