NPI | 1184021818 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2279C0205X Respiratory Therapist, Registered, Critical Care (Licence: WA LR60478881) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: WA 61502922) |
Enumeration Date | 2014-11-24 |
Last Update Date | 2024-08-23 |