NPI | 1568601730 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: CA 4853490) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2009-02-12 |
Last Update Date | 2013-05-31 |