| NPI | 1992416549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider (Licence: TN 215411130907) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2022-12-05 |
| Last Update Date | 2022-12-14 |