| NPI | 1760218366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 10027289) |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2024-09-10 |