| NPI | 1548384233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: AK CMG414) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: AK CM1249) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-12-06 |