| NPI | 1114008265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: PR 26579) |
| Additional Taxonomies | 2278G1100X Respiratory Therapist, Certified, General Care (Licence: PR 1891) |
| 247200000X Technician, Other (Licence: PR 7758) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-08 |