| NPI | 1053556902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: RI RN46379) |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered (Licence: RI RCP00803) |
| Enumeration Date | 2008-12-06 |
| Last Update Date | 2008-12-06 |