| NPI | 1730406083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: CA A4262799) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2019-10-01 |