| NPI | 1174717748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2278P1006X Respiratory Therapist, Certified, Pulmonary Function Technologist (Licence: VA 0117000661) |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2010-12-23 |