| NPI | 1447915145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 227900000X Respiratory Therapist, Registered (Licence: GA 9482) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT015097) |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2021-11-08 |