| NPI | 1477781284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: OR 10031294) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 615007) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2024-10-02 |