| NPI | 1760115992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2279C0205X Respiratory Therapist, Registered, Critical Care |
| Additional Taxonomies | 2279P3900X Respiratory Therapist, Registered, Neonatal/Pediatrics |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2022-07-06 |