| NPI | 1417102732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: OR 15-2418) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OR 3890) |
| 2278E1000X Respiratory Therapist, Certified, Educational (Licence: OR P-898021) | |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2022-01-08 |