| NPI | 1447875083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246YR1600X Spec/Tech, Health Info, Registered Record Administrator |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2020-06-09 |