| NPI | 1235269309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2472E0500X Technician, Other, EEG (Licence: 2472E0500X) |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered (Licence: GA 3886) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2014-10-07 |