| NPI | 1255645495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 2279C0205X Respiratory Therapist, Registered, Critical Care (Licence: OK 1836) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2020-02-17 |