| NPI | 1588823223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: FL 674758296) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: FL 674758298) |
| Enumeration Date | 2008-06-07 |
| Last Update Date | 2008-06-07 |