| NPI | 1851809537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 297618-1) |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered (Licence: NY 010061) |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2018-01-17 |