| NPI | 1972756799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: FL 003443500) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL IMH11265) |
| 1744R1102X Specialist, Research Study | |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2013-06-11 |