| NPI | 1386173672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 227800000X Respiratory Therapist, Certified (Licence: OK 2403) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-07-21 |