| NPI | 1801541339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201606844RN) |
| Enumeration Date | 2022-02-14 |
| Last Update Date | 2022-02-14 |