| NPI | 1063032134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2278P4000X Respiratory Therapist, Certified Patient Transport |
| Enumeration Date | 2020-04-19 |
| Last Update Date | 2020-04-19 |