| NPI | 1659589976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2279C0205X Respiratory Therapist, Registered, Critical Care |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered |
| 2279P3900X Respiratory Therapist, Registered, Neonatal/Pediatrics (Licence: NY 005766) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2025-09-11 |