| NPI | 1629519566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy (Licence: OH 246rp1900X) |
| Enumeration Date | 2017-03-11 |
| Last Update Date | 2023-12-18 |