| 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 |