| NPI | 1700358157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MD R127188) |
| Enumeration Date | 2018-12-26 |
| Last Update Date | 2018-12-26 |