| NPI | 1871081604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374700000X Technician (Licence: CA R1251560517) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2024-02-28 |