NPI | 1801527775 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: LA 114818) |
Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: LA 210785) |
227900000X Respiratory Therapist, Registered (Licence: RRT.L03281) | |
Enumeration Date | 2022-06-22 |
Last Update Date | 2023-09-20 |