| NPI | 1881259042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: MI 6802089266) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-12-16 |