NPI | 1609069954 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 041-348127) |
Additional Taxonomies | 227900000X Respiratory Therapist, Registered (Licence: IL 194.002475) |
Enumeration Date | 2007-08-21 |
Last Update Date | 2007-08-21 |