| NPI | 1821120890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 227900000X Respiratory Therapist, Registered (Licence: FL RT1230) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL PN413911) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2007-09-12 |