| NPI | 1992523989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 247200000X Technician, Other |
| 174400000X Specialist | |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2026-07-28 |