| NPI | 1831800382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 225XH1300X Occupational Therapist, Human Factors |
| Enumeration Date | 2022-12-06 |
| Last Update Date | 2023-06-05 |