| NPI | 1861976227 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2278P3900X Respiratory Therapist, Certified, Neonatal/Pediatrics (Licence: CA 26517) | 
| Additional Taxonomies | 2278C0205X Respiratory Therapist, Certified, Critical Care (Licence: CA 26517) | 
| 2278P4000X Respiratory Therapist, Certified, Patient Transport (Licence: CA 26517) | |
| Enumeration Date | 2018-09-21 | 
| Last Update Date | 2018-09-21 |