NPI | 1770969495 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2015-08-04 |
Last Update Date | 2022-08-29 |