| NPI | 1104121482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 227900000X Respiratory Therapist, Registered (Licence: FL RT9647) |
| Additional Taxonomies | 2279P3900X Respiratory Therapist, Registered, Neonatal/Pediatrics |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2011-01-18 |