NPI | 1669952594 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA 702528) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2018-08-20 |
Last Update Date | 2019-02-08 |