| NPI | 1770319709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2278G1100X Respiratory Therapist, Certified, General Care (Licence: MN 5550) |
| Additional Taxonomies | 227800000X Respiratory Therapist, Certified |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2024-09-09 |