| NPI | 1922655760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH c.2002635-TRNE) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OH CDCA.170802) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2021-05-04 |