| NPI | 1730318957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA20180) |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered (Licence: CA 00023819) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2012-09-12 |