| NPI | 1144654153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN5145767) |
| Additional Taxonomies | 227800000X Respiratory Therapist, Certified (Licence: FL TT 15573) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2013-08-27 |