| NPI | 1588843783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2278P3900X Respiratory Therapist, Certified, Neonatal/Pediatrics (Licence: 9138144) |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered (Licence: NV RC198) |
| 227900000X Respiratory Therapist, Registered (Licence: OR RT-P-10119074) | |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2007-10-24 |