| NPI | 1841676954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: OK 307400) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OK 62258) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2016-02-26 |