| NPI | 1588464028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251B00000X Case Management (Licence: UT F25-118163) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: UT F25-118163) |
| Enumeration Date | 2025-03-14 |
| Last Update Date | 2025-07-16 |