| NPI | 1235369737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL mh9918) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL mh9918) |
| 101YM0800X Counselor, Mental Health (Licence: FL mh9918) | |
| 227900000X Respiratory Therapist, Registered (Licence: FL rt9048) | |
| 2279C0205X Respiratory Therapist, Registered, Critical Care (Licence: FL rt9048) | |
| 2279P1004X Respiratory Therapist, Registered, Pulmonary Diagnostics (Licence: FL rt9048) | |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2016-04-18 |