| NPI | 1184330276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AL 1-190654) |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered (Licence: FL RT14193) |
| 227900000X Respiratory Therapist, Registered (Licence: AL 3824) | |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-01-23 |