| NPI | 1720403488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2278E1000X Respiratory Therapist, Certified, Educational (Licence: CA 26804) |
| Additional Taxonomies | 227800000X Respiratory Therapist, Certified (Licence: CA 26804) |
| 2278H0200X Respiratory Therapist, Certified, Home Health (Licence: CA 26804) | |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2014-03-04 |