| NPI | 1730412396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: TX 102114) |
| 246Y00000X Spec/Tech, Health Info | |
| 251E00000X Home Health | |
| 246YC3302X Spec/Tech, Health Info, Coding Specialist, Physician Office Based | |
| 174H00000X Health Educator | |
| 172V00000X Community Health Worker | |
| 183700000X Pharmacy Technician (Licence: 260101030750018) | |
| 247200000X Technician, Other | |
| 172A00000X Driver | |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2025-11-14 |