| NPI | 1538611926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: NV 2103246352) |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2018-05-02 |