| NPI | 1598796203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: PA 6000003565) |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered (Licence: PA YM0035534) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2025-09-11 |