| NPI | 1497898100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2279P3900X Respiratory Therapist, Registered, Neonatal/Pediatrics (Licence: MN 2165) |
| Additional Taxonomies | 2279P3900X Respiratory Therapist, Registered, Neonatal/Pediatrics (Licence: WI 2716) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2007-07-08 |