NPI | 1639298185 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: CA NA) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: CA NA) |
Enumeration Date | 2007-03-28 |
Last Update Date | 2007-07-08 |