NPI | 1659337749 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: CA G 32293) |
Additional Taxonomies | 172V00000X Community Health Worker (Licence: CA G32293) |
332U00000X Home Delivered Meals (Licence: CA G32293) | |
251X00000X Supports Brokerage (Licence: CA G32293) | |
171M00000X Case Manager/Care Coordinator (Licence: CA G32293) | |
Enumeration Date | 2006-04-26 |
Last Update Date | 2025-09-08 |