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Individual
MR. JAMES HERNANDEZ
Active
Individual
MR. JAMES HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
999999
NONE
—
Enumeration date
02/01/2018
Last updated
02/01/2018
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