| NPI | 1194981027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 553651) |
| Additional Taxonomies | 2278C0205X Respiratory Therapist, Certified, Critical Care (Licence: CA 00016033) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2008-07-30 |