| NPI | 1003101015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2278G1100X Respiratory Therapist, Certified, General Care (Licence: NV RC2219) |
| Additional Taxonomies | 2278G1100X Respiratory Therapist, Certified, General Care (Licence: CA 29949) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2014-03-26 |