| NPI | 1831816511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2279G1100X Respiratory Therapist, Registered, General Care (Licence: MO 100275) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2004004424) |
| 163W00000X Registered Nurse (Licence: IL 041494547) | |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2022-10-24 |